Lessons to be Learned from the Connor Donaldson Inquest

Once again, a child’s death caused by anaphylaxis is receiving attention in the media, this time in the UK. The loss is yet another in a long line of horrific, preventable tragedies, but there are lessons to be learned from the details of the child’s exposure and the subsequent attempts at first aid.

Connor Donaldson, a 12 year-old boy from Greater Manchester with severe asthma and a severe peanut allergy, died October 19, 2013 after ingesting a few bites of curry the family had taken out from a nearby restaurant.

His mother had discussed the allergy with a staff member of the restaurant over the phone prior to ordering. She was assured that their dishes would contain no peanuts.

After taking a few bites, Connor began gasping for breath. His mother immediately administered the boy’s asthma inhaler which was insufficient to restore his breathing. Connor quickly lapsed into cardiac arrest and was administered CPR by his mother and the paramedics that arrived on the scene. He was pronounced dead at the hospital a short time later.

It was found that the kitchen staff used the same ladles and spoons to prepare all curry dishes, including those with nuts. It was also determined that one paste used as an ingredient in the child’s dish tested positive for nut residue, while another, an almond paste, was actually 50% peanut powder, often used as a cheaper filler in the preparation.

Lessons to be Learned

We urge you to contact your child’s allergist to create an emergency action plan detailing which medications to administer under which circumstances.

If your child has a severe food allergy and is also prone to asthma attacks, it is especially important to know when to use the asthma inhaler and when to administer epinephrine via auto-injector. Make sure family members and everyone responsible for your child’s care are well versed in the plan and trained to locate and administer the medications in an emergency.

We strongly advise those with severe allergies and those caring for children with such allergies to take special care when considering eating food that you have not prepared. Some suggestions:

Avoid establishments that prepare foods for which your allergen is a common ingredient. As an example, Chinese and Thai food often contain peanuts and tree nuts, and fresh (as opposed to dry) pasta is often prepared with eggs;

Visit the establishment in person in advance and speak directly to the owner or manager;

Let them know that you live in the area, that you are part of a tightly knit community of food allergy sufferers, and that honest answers are important to you and the community. The subtext here is that you live close by, that honesty and cooperation will be appreciated by the community, while evasiveness will draw their ire;

Discuss the severity of the allergy with them, making sure they understand and are able to repeat your concerns. If they are flippant or dismissive, leave;

Ask them whether your allergens are ever prepared in the establishment, or whether the ingredients themselves may contain the allergens. If you feel the manager is hedging or being evasive, leave. (If you avoid packaged foods because they are manufactured on equipment that also processes your allergen, keep in mind that this is the restaurant equivalent.)

Ask to visit the kitchen. If the manager refuses, leave;

Ask whether your food will be prepared in a separate area with separate utensils, pots, pans, etc. If you are not satisfied with the response, leave;

Ask whether your food can be served/packaged separately, preferably by the manager or chef. If you are not satisfied with the response, leave.

Remember, you are placing your trust in an establishment to keep you and your family safe. Should you have any reason to doubt their professionalism or commitment to your safety, leave. Trust your gut instincts if something seems wrong.

We understand that this is an onerous process. We suggest you start with a small circle of local establishments that have earned your trust and have management which which you have developed a rapport, then expand the circle slowly and carefully.

Remember to remind the staff of your special circumstances each and every time you visit!